If you are having trouble viewing this email, please click the following link.
http://www.visioncareprofessional.com/emails/genentech/newsletter/31/index.html

Successfully Managing Reverification of Insurance Benefits
By Juliann Schaeffer, Contributing Editor

Advertisement
For patients, the dawn of a new year brings well-meaning resolutions and a winter chill. For physician practices, it brings an onslaught of new insurance programs. As practice administrators know, new programs mean changes in benefits, which, as of late, often mean higher premiums, out-of-pocket expenses and copays for patients.

Changes in insurance plan benefits can cause headaches for patients and staff alike, but successful management of insurance benefit reverification is essential. Overlooking this issue can have lasting effects, according to Tracy Rummans, OCS, director of patient accounts/insurance, Retina Consultants of Southwest Florida, PA in Ft. Myers.

While patient care is of the utmost importance, an office must be able to keep its doors open and provide care — and that necessitates appropriate reimbursement. According to Rummans, verifying insurance benefits is the first step in the collection process.

Implementing practice efficiencies can ensure that practices receive proper payment, allowing physicians to concentrate on what they do best — practice. When searching for ways to streamline reverification of benefits, it's an education all around.

Keep Staff in the Know
First, ensure your staff is familiar with the most prominent plans in your area, says Rummans. She says that because a large percentage of retina patients are seniors, many have the same plans. "My insurance staff is aware of these plans and is trained to use the plan websites or make the necessary pre-visit phone calls to ensure a patient's visit will be efficient," she says.

Rummans says the practice has set specific patient account and chart guidelines for other staff members to follow, which helps to determine which patients will need reverification and further streamlines the process. For example, using a function of their practice management program, the staff created a user-defined field to describe the type of insurance each patient has. "Staff members who schedule appointments must complete this field with one of our predefined choices," says Rummans. "The benefit staff member then runs a daily report that sorts appointments by date and insurance type." This helps with practice efficiency.

Because the beginning of the year brings the highest workload for benefit reverification, Rummans says practices should consider having extra staff on hand during the first quarter each year.

Benefits of Informed Patients
Staff members aren't the only individuals who can benefit from education. According to Rummans, a more informed patient often equates to a patient who pays.

"By verifying benefits before a patient is seen, and periodically thereafter, practice members can have a more informed conversation with patients concerning the financial aspects of their visits," she says. "We find if patients are more informed, they're more likely to pay or at least set up payment arrangements."

A key instance in which patient education is crucial is when an established patient's coverage changes and it affects their treatment. In this instance, Rummans says staff members review the patient's records, and then contact the patient to discuss the specifics, especially if it means an increase in out-of-pocket expenses.

According to Rummans, being proactive can save staff headaches down the line and increase patient satisfaction.

Winning the Paperwork Game
Convincing patients to come early so they can complete paperwork is difficult. One potential solution is to make forms available beforehand, so patients walk in the door with paperwork already completed.

Retina Consultants of South Florida provides referring physicians with new patient folders that include the forms needed for an initial patient visit and this has helped the staff. Patients also can access forms on the practice's website. "The forms can be downloaded, completed and brought into the office on the day of the appointment," says Rummans. For patients who have to work on forms in the office on the day of the visit, it's a good idea to have designated staff members available to help patients complete their forms.

Noting the importance of arriving early (via phone appointment reminders or on printed documentation) may help those patients who complete paperwork in the office. But for patients who don't arrive early, your best approach is a friendly demeanor and a flexible attitude.

Retinal Physician | 323 Norristown Road, Suite 200, Ambler, PA 19002 | 215-646-8700
If you prefer not to receive e-mail from Retinal Physician, please use the following link to remove your e-mail address from this list: Unsubscribe
This message was transmitted by PentaVision LLC | 323 Norristown Road, Suite 200, Ambler, PA 19002 | 215-646-8700
View the PentaVision LLC Privacy Policy | Contact Us - Please do not reply to this e-mail message.
Please make sure our e-mail messages don't get marked as spam by adding visioncareprofessionalemail.com to your "approved senders" list.